Christopher Betts, Business Development and Sales Leader, UK, for DNV Imatis, explores how intelligent clinical communication can reduce hospital noise, improve patient rest and support more efficient care delivery.
In a modern hospital, the high-pressure environment is often dominated by the repetitive chime of call bells. While these alarms are intended to safeguard patients, they frequently become a source of alarm fatigue for staff and a barrier to rest for those in recovery. At the Royal Cornwall Hospitals NHS Trust (RCHT) in south-west England, which serves a population of over 500,000 people across Cornwall and the Isles of Scilly, a project known as the Silent Hospital has attracted international interest by demonstrating that the future of patient-centred care lies in replacing this noise with intelligent, data-driven communication.
The silent hospital: A new era for RCHT
Before the implementation, the Trust’s postnatal ward, known as the Wheal Fortune, relied on legacy nurse call bells that generated high levels of ambient noise. This noise was at odds with the Trust’s commitment to creating a calm and restorative space for patient recovery. Patient feedback revealed that 57% of patients reported difficulty sleeping due to these disturbances. The noise levels also caused widespread alarm fatigue among staff. When repeated and non-prioritised alerts become background noise, they lose their urgency, making it harder to prompt timely action and increasing the cognitive load on clinical teams already operating at high capacity.
The lack of clear ownership for these audible alerts meant the ward’s staff often had to make phone calls or physically search for colleagues to determine who was responsible for a patient request. This resulted in fragmented communication and increased stress during shift handovers. The ward also lacked the structured digital tools necessary to support these handovers or to provide real-time visibility of patient requests and staff activity.
As a result, the Trust recognised the need for a quieter, smarter approach to clinical communication: one that could improve responsiveness, enhance the patient experience and complement the Trust’s forthcoming new EPR system.
The RCHT digital team ensured seamless connectivity with the upgraded Wandsworth iPin nurse call system. To avoid disruption to live operations, the project team created a virtual, cloud-based iPin test environment, allowing for the safe development and testing of messaging protocols before going live.
The customisation of the system through co-design was central to the project’s success. RCHT held a series of workshops involving frontline staff, clinical leads, project managers and IT teams to shape the workflows and the interface design. This ensured the technology mirrored the realities of the ward. Recognising the importance of staff confidence, the team developed a ward-level fallback option, allowing staff to revert to audible alerts if required during the transitional period. Additionally, the alarm management solution provides visual dashboards and structured messaging tools to support patient handover, task coordination and escalation processes.
Training, engagement and success
To help encourage successful adoption, the Trust implemented a robust training model. This included a train-the-trainer programme and the deployment of on-ward support staff who could provide immediate assistance to their colleagues. The Trust recognised that ensuring staff buy-in and confidence was as critical to the project’s success as the technical implementation.
Ongoing engagement included ward signage and patient-facing leaflets to explain the pilot, ensuring that those in the ward understood why the bells had been silenced. Regular staff feedback forums and surveys allowed for improvements to the system. The project also maintained high levels of transparency through the involvement of a Patient Leader and the Trust’s Accessibility Advisory Group, ensuring that the system remained inclusive and patient-centred.
Midwives, nurses and ward staff served as the primary users of the mobile devices for the silent alert system. Ward managers and clinical leads were responsible for the clinical workflows and quality monitoring. IT and digital teams managed system security, integration and ongoing support. For patients and their families, the result was a calmer and more supportive care environment.
Measurable impact
The shift to silent, targeted communication has delivered significant results. The project achieved a 50% drop in ambient noise levels and a 12% increase in patient-reported sleep quality. From an operational efficiency perspective, the Trust recorded a 0.5-day reduction in Average Length of Stay, which translates to estimated annual savings of £74,942 for the 25-bed ward. For a 700-bed Trust, this improvement in efficiency could equate to around £2.1m in annual utilisation value.
Beyond the numbers, the project significantly enhanced safety by reducing alarm fatigue and creating more structured, silent handovers. These outcomes were achieved by replacing unstructured, audible alerts with a structured digital transfer of care between shifts. With call bell response data now enabling performance tracking and resource planning, the Trust can make data-driven improvements to its care delivery.
Wider adoption at RCHT
Following a successful two-year pilot on the Wheal Fortune postnatal ward, the Trust has extended the Silent Hospital pilot to antenatal services, including the Wheal Rose Ward, Maternity Triage and the Day Assessment Unit. This marks an important step in testing the technology in a higher-acuity clinical setting.
During the six-month pilot, the Trust will evaluate reductions in noise levels, impacts on staff wellbeing and productivity, improvements in patient experience and potential improvements in patient length of stay.
Wider adoption at RCHT
While the Silent Hospital project focuses on targeted communication and alarm management, the platform serves as a broader digital foundation for hospital-wide coordination. In addition to the smart alarm management capabilities seen at RCHT, the platform enables healthcare providers to coordinate a range of critical functions, including:
- Clinical workflows and patient flow: Aligning patients and resources in real time to improve situational awareness throughout the patient journey.
- Real-time patient and bed management: Giving staff a real-time overview of patients, beds and capacity to help reduce bottlenecks and improve operational flow.
- Coordinated task management: Helping hospital operations run smoothly through real-time coordination of facilities management tasks and requests.
- Outpatient flow coordination: Improving outpatient flow through real-time coordination of patients, staff and clinical activities.
By integrating data, workflows and communication tools into a single operational picture, this helps hospitals build a digital infrastructure that connects teams and improves care delivery.
